Prenatal diagnosis of congenital toxoplasmosis
Prenatal diagnosis of congenital toxoplasmosis
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DOI：
10.1002/pd.476
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发表时间：
2002-12-01
影响因子：
3
通讯作者：
Michalas, S
中科院分区：
文献类型：
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作者：
Antsaklis, A;Daskalakis, G;Michalas, S
对93例妊娠期弓形虫血清转换孕妇进行胎儿弓形虫病产前诊断。方法：（1）93例受试者腹腔穿刺接种;（2）T.用聚合酶链反应（PCR）检测弓形虫DNA（79例）;弓形虫特异性IgM抗体（13例受试者）。所有的病人都进行了一系列的超声波扫描，以检测那些可能与先天性弓形虫病有关的胎儿异常。18例妊娠（19.4%）有垂直传播的证据。11/18例（61.1%）羊膜鼠接种试验阳性，10/12例（83.3%）PCR阳性。两种方法联合应用可对17/18例感染胎儿进行产前诊断（94.4%）。所有接受脐带穿刺检测弓形虫特异性IgM抗体的患者均为阴性结果。然而，在上述两例胎儿弓形虫病检测羊水研究。在5例感染胎儿中，超声检查结果异常。所有有垂直传播证据的妊娠都被终止，而其余的妊娠则正常足月。目前的数据表明，羊水研究，最好是PCR扩增弓形虫DNA，是最好的诊断工具，检测垂直传播的孕妇在怀孕期间血清转换。版权所有（C）2002约翰威利父子有限公司
Ninety-three pregnant women with Toxoplasma gondii seroconversion during pregnancy underwent prenatal diagnosis of fetal toxoplasmosis. The following tests were used: (1) amniocentesis for mouse inoculation (93 subjects), (2) amplification of T. gondii DNA by polymerase chain reaction (PCR) (79 subjects), and (3) cordocentesis for the detection of T. gondii-specific IgM antibodies (13 subjects). All patients had serial ultrasonographic scans to detect those fetuses with abnormalities that could be associated with congenital toxoplasmosis. Eighteen pregnancies (19.4%) had evidence of vertical transmission. A total of 11/18 (61.1%) had positive amniotic mouse inoculation test, while 10/12 (83.3%) had positive PCR results. The combination of both tests allowed the prenatal diagnosis in 17/18 infected fetuses (94.4%). All patients who underwent cordocentesis for the detection of T gondii-specific IgM antibodies had negative results. However, in two of the above cases fetal toxoplasmosis was detected by amniotic fluid studies. In five of the infected fetuses there were abnormal ultrasonographic findings. All pregnancies with evidence of vertical transmission were terminated, whereas the remaining pregnancies proceeded normally to term. The present data showed that amniotic fluid studies, preferably PCR amplification of T gondii DNA, are the best diagnostic tools for the detection of vertical transmission in pregnancies with seroconversion during pregnancy. Copyright (C) 2002 John Wiley Sons, Ltd.